Below are some items you may want to address before you return home . You may need to make modifications that require professional installation, especially if you are in a wheelchair.

Entryways and hallways should have a 32-inch clearance to accommodate people in wheelchairs. When doors do not open as wide as hinges were designed, application of a lubricant allows the hinges to work as they were designed. This extra space can allow a person using a wheelchair or walker to fit through the doorway. The edges of a swelled door may need to be shaved to allow for extra space as well. An uneven threshold should be fixed or changed to prevent tripping and allow easier wheelchair access. A portable ramp is often an affordable solution.

Stroke survivors who are unable to grasp with their fingers or twist their wrists to open doors can use a downward movement of their fist to open lever door handles more easily than regular doorknobs. The location of the knob may need to be moved as well. Swing away hinges, folding doors, or pocket doors can make passage through doors less difficult. To provide more space or clearance in doorways, doors between rooms can be removed.

To allow for movement in a wheelchair, furniture may need to be moved and thick rugs may need to be replaced. Rugs should be moved unless they are sufficiently secured to the floor with some sort of non-skid tape.

While slick surfaces should be avoided when possible, wearing non-skid shoes can prevent slipping. Secure carpets or runners can be installed in hallways or stairwells for traction. Handrails provide support while going up and down stairs. They may be attached to reinforced walls or the floor or ground. Outdoor handrails need to withstand weather conditions. A ramp may need to be added as well.

A stair glide or stair lift is a way to transport a person up or down stairs while the person is seated. A person transfers to the seat and rides up or down the stairs on a track. This electrical technology may cost several thousand dollars to install. A platform lift, on the other hand, is similar to a small elevator. This lift transports a person up or down stairs. The person can step onto the platform or roll a wheelchair onto the platform and then the platform electrically moves the person to a different level. Platform lifts are available for indoors or outdoors.

Pathways should be clear of clutter and electrical cords. Extension cords can be used to reroute cords along walls, and cords should be secured to the floor or walls when possible. Cords with frayed ends should be discarded and replaced.

Individuals who do not require a wheelchair but find it difficult to move from place to place on their own may need to use a cane, walker, or scooter. They may feel more comfortable if handrails or grab bars are mounted to the walls of the home.

Phones should be easily accessible for the stroke survivor in every room of the house. A cordless phone or a wearable call button may be necessary and would prevent tripping on a phone cord. Emergency phone numbers should be posted in a highly visible area.A large button phone is easier to read and use for patients with limited movement or vision problems. High contrast such as dark on light or light on dark also helps people with vision problems to read the numbers and words on phones. A picture phone reduces the need to remember phone numbers or to press several buttons to make a call. The phone can be programmed to fit a person’s individual needs. A symbol, drawing, or photograph corresponds to emergency numbers and numbers of family or friends. Install smoke detectors and carbon monoxide detectors and check them regularly. Have a well-thought-out and posted fire escape plan.

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This project is supported in part by the NIH Specialized Programs of Translational Research in Acute Stroke (SPOTRIAS) Network, and NINDS grant 3P50NS055977 to Washington University in St. Louis School of Medicine and UT Southwestern Medical Center.